Soulbrite Clinical Associates

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SOULBRITE CLINICAL ASSOCIATES

Practice address

1550 Spring Rd Ste 225
Oak Brook, IL 60523-1389

Phone

(630) 403-8735

NPI assigned

Sep 11, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David Hendricks, MA, LCPCNPI 1154630846

Title

President

Phone

(630) 403-8735

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Hendricks, MA, LCPC

  • Behavior Analyst
  • Oak Brook, IL
  • NPI 1154630846
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571702400000",
    "number": "1578046066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 SPRING RD STE 225",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231389",
            "telephone_number": "630-403-8735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 SPRING RD STE 225",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231389",
            "telephone_number": "630-403-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOULBRITE CLINICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-11",
        "last_updated": "2019-10-22",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-403-8735",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.